Forman, Dale
Forman, Dale is an sole proprietor health care provider with primary practice located at 12836 Old Glenn Hwy , Eagle River AK 99577-7041. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Forman, Dale can be contacted via phone (907) 726-5330.Contact Information
Primary practice address
12836 Old Glenn Hwy
Eagle River AK 99577-7041
Phone: (907) 726-5330
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 0-13-5716 | South Carolina |
Profile Details
| NPI number | 1023432457 |
|---|---|
| LBN Legal business name | Forman, Dale |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 5th, 2014 |
| Last updated | Feb 5th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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